So why is it that some people are super sensitive to mounjaro and others just aren’t ?

[supadoope]

I’m a slower loser on MJ than a lot of others.

I’ve had varying degrees of suppression as well as nasty side effects. I’m on 7.5mg now. I slowly crept up to it, to avoid side effects but weight loss is slow and suppression is good but not incredible.

I don’t binge much anymore. I’m averaging at around 1.200 calories a day, I’m quite active.

I lose 2 kg a month maybe. It’s slow but I’m losing.

why do I need so much more MJ than others who stay on 2.5 mg and lose 30 kg? Or on 5 mg for 6 months and lose 1 kg a week consistently.

am I broken ? Is it my hormones ? Thyroid checks out fine on blood tests.

starting weight was around 101 last year January. Then I lost 8 kg. Had to go off the meds for side effects, gained 3 kg. Then lost 3 kg, then went back on and it took ages to lose the 3kg.

I am at 89 kg now so it’s moving in the right direction and I’m desperate to get down to 65-70 kg.

it’s just taking so long ! No one has said anything about my 11 kg weight loss as it’s so so so slow. But to be honest, I would rather people didn’t comment. Perhaps I’ll have less loose skin too ?

but why are there people who it works for so extremely quickly on such low doses and others who need higher doses ? I go up doses quite slowly.

so over a few weeks like this :

5mg

5.5mg

6.2 mg

7 mg

7.5 mg

is that the problem ? I just don’t want to vomit and be in bed for days ( as happened when I first started ).

But it is working for you.....

I'm like you, and I am fairly sure it's my age and my dieting history. I have lost weight far more quickly and done some pretty extreme diets through my life. I've weight cycled or yoyoed for over thirty years. I got to my forties and my ability to restrict evaporated but I kept bingeing (having always cycled between the two). If I managed to diet, I would lose nothing at all - even going low carb, which used to produce dramatic results. I can only assume I broke my metabolism through treating my body so badly for so long and that - possibly combined with perimenopause though I'm not sure I'm in that yet - made my body extremely reluctant to let go of weight.

MJ is slow for me - I drop a pound, stay static for ten days or so, maybe lose another but sometimes gain and have to go through it all again. It adds up though. Nine months in and I'm heading for a four stone loss. I'm very careful about increasing doses because of nasty side effects that I'm keen to avoid, having suffered badly at the start.

I'm weight training and doing my best to build or at least maintain muscle. I hope that slow weight loss will be good for my skin and I also hope that it won't be as damaging to my metabolism. I know from bitter experience that rapid weight loss has always led to dramatic regain for me. I hope that doing it this way helps me to sustain it in the long term - and because it works, even if it works slowly, I have the faith and the optimism to keep going.

Not bingeing anymore in itself is such a victory and such an improvement to my quality of life, I'd count that as a major win to be honest.

I'm on 10mg now and that seems Ok in terms of appetite but still quite slow. I think lots on MN seem to be on the lower doses so maybe that skews things a little.

I think there are many ways that people end up very overweight so whatever approach you take to deal with that isn't going to be right for everyone. It's like the way that some anti-depressants work really well for some people but others need something different.

But I think what's really important is that you're not binging any more. I don't know about you but I could stop losing weight tomorrow but as long as MJ keeps stopping me from binging so I don't go to bed feeling sick and hating myself for what I'd eaten then that would be enough for me.

I think some people (like me) don't have a lot of side effects so can go up doses quicker.

I don't know why some respond to lower doses and others need a higher dose to respond though. I'd love to know.

I have lost almost 25% of my body weight in 3 to 4 months. So clearly.responding well. But I have no idea why!!

Tbh I think a lot of people who say they have weight loss from day one 2.5mg are having a placebo effect combined with being in the mindset to diet.
If it really worked that fast at the titration dose I think the manufacturer would be promoting that.
I felt zero effect until 7.5mg

I expected to lose slower than most due to my fluctuating weight history and my age (later stages of perimenopause).

As to the response - mine has been varied. Started off with a normal/good response on 2.5 mg - I did need more after the 4 weeks though. I thought I was being sensible going up in a couple of steps to get there - I guess I was because I had fairly bad side effects/too much suppression before getting to 5 mg. Bolded is those weeks, so took it even slower. I seem to swing between being under-suppressed and over with a small change in dose.

Pen 1 (2.5 mg) - 2.5, 2.5, 2.5, 2.5, 3.2 - lost 10.6 lbs
Pen 2 (5.0 mg) - 4.2, 4.2, 4.6, 2.5, 4.2 - lost 6.4 lbs
Pen 3 (5.0 mg) - 4.2, 4.4, 3.3, 3.75, 3.75 - lost 7.7 lbs
Pen 4 (5.0 mg) - 3.75, 4.2, 4.2, 4.2, 4.2 - lost 6.5 lbs
Pen 5 (5.0 mg) - 4.2, 4.5, 4.6, 4.6, 4.6 - lost 3.9 lbs
Pen 6 (5.0 mg) - 4.6, 5.0, 5.0, 5.0, 5.0 - gained 0.6 lbs
Pen 7 (5.0 mg) - 5.8, 5.8, 6.3, 6.7 - lost 2.0 lbs
Pen 8 (7.5 mg) - 6.9, 7.5, 7.5, 8.1, 8.8 - lost 1.4 lbs
Pen 9 (7.5 mg) - 9.5, 10.0 - lost 2.4 lbs in a week so far (most prob on 10 as 1.5 day gap between injection (Thu) and WI (Sat)).

In total I've lost about 40 lbs in 40 weeks. I think I've been under-suppressed since before Christmas and have lost very little as a result. I was happy to me maintaining I think if I am honest. Wine crept in over Christmas and I was making little effort apart from taking my jab so that needs to be factored in too.

Been braver going up the doses recently and finally 10 mg seems to be working. Plan to stick here until it doesn't. I also haven't had a period since Christmas (was regular 26 day cycle before that) - I'm 52 so that could be the menopause starting properly, so that is another thing to consider.

I liken it to the menopause - some people have a horrible time of it whilst others breeze through...I don't know the answer though. I'm just hopeful I can get this going again now and lose some more weight (along with more effort on the diet and exercise front).

I think this is an interesting comment. I've lost 35 lbs over six months and have not gone further than 5 mg. I lost a stone in three weeks on 2.5 mg and since then, it's been a pound or so a week, which I am happy with. I don't count calories as I know roughly what will work and what won't. I did wonder if it was a placebo effect, but it surely can't be for this length of time. I do definitely have appetite suppression, and a few minor side effects, and I also have much less 'food noise'. These are things people on higher doses do comment on. So while I think there can be a placebo effect, I don't think it explains why some people can lose on smaller doses over time than others.

I forgot to mention earlier (in my post about being on 10mg) that I'm on MJ for some weight gain from other meds maybe this makes a difference for me?

There are also plenty of people on the board who cannot tolerate 2.5 mg at the start - so revert to doses of 1.25 mg and then build up very slowly. I had quite bad side effects on 4.6 mg (and again later on 4.4 mg) and was definitely very suppressed on 4.2 mg the two weeks before that (why didn't I stop there?! Hindsight...). I am pretty convinced that 2.5 mg wasn't just the placebo effect for me (although I do think there was an element of that, which made the weight loss better - no wine for a start).

I am assuming that manufacturers recommendations are based on how the majority of people will react to it - there will be a significant minority of people are either side of that. They will also need to consider managing expectations (much easier to push that it is not expected to start working on 2.5 mg and people be pleased when it does than the other way round) and keeping it simple for a self administered drug.

I’m on the SheMed clinical trial and appear to be one of the lucky ones in that the suppression and losses happened straight away. I’ve just done the final dose of pen 2 (5ml) and am staying on that dose.

I’m in the later stages of perimenopause and have noticed some interesting changes that I can only attribute to the MJ:

Changes in my period - first time in several years I haven’t had horrendous head/stomach ache and no paracetamol needed!
Changes in food habits - went out for a meal last weekend, and even though I did make considered choices, I couldn’t finish it and I didn’t want pudding!
No interest in chocolate/biscuits.

I’m 7 weeks in (technically six as I cocked up the first injection) and have lost 2st 9lbs.

I’ve had no side effects, so have been lucky in that way too. My husband is on the tablet version for T2 diabetes and was horrendously sick until he got used to it, so I’m well aware that I’m one of the lucky ones! It’s amazing how it it affects different people in different ways.

Everyone differs in how they react to drugs. Weight loss on it also depends on what and how much you eat and move.

That's interesting. I'm one of those who started losing from day 1, but I really believed it wasn't going to work for me after a lifetime of failed diets. I've reached BMI 23 (from 31) after 3 2.5mg pens and 2 and a half 5mg pens. I was afraid of side effects so didn't want to go any higher, I was happy with a slower weight loss. I'm sure there must be some physical reason why it works for some people but not for others.

Clinicians will tell you that human bodies are all different and there's a range of responses to almost all medications, often with very little rhyme or reason. Some patients respond really well to a painkiller where others need higher doses to get a comparable effect, Mounjaro is the same. This is why most medications have a dose range, rather than just one standard dose, and why pharmacists can spend so much time calculating doses, sometimes based on body weight, kidney function, liver function, etc. but sometimes just based on the response to previous doses and with no obvious correlation to any measurable parameters.

It is possible that years of dieting and our age may affect normal hormonal function as @InTheHallway said so GLP1, leptin, ghrelin, etc levels may all play a part but, as far as I know, those are not measurable so we will have to continue groping in the dark as regards dosage.

Speaking personally, I have had very few side-effects, almost zero, but have needed to get to higher doses to get much effect although I can't say definitely those two things are linked. Like @supadoope I have not had much appetite suppression but have reduced "food noise" so am better able to resist cravings and urges to binge. Losing 2st 9lb in 3 weeks, like @Kaggi9, would be the stuff of dreams for me (although I would not like to lose too much too fast as I am older and would risk loose skin).

See, I could say that I think that the reason some people don't lose weight until the higher doses is because they were eating carby junk food and UPFs and it took them that long to change and clean up their diets and/or start measuring calories properly...

But the fact is we are all different. The real problem is that there is starting to be this assumption that those that are successful using lower doses are somehow superior or doing it better. Which is not just illogical but also simply bollocks. Some people are constantly very ill and nauseous and cannot tolerate the drug even at the lowest dose, and some people (15% in fact) do not respond to MJ at all at any dose.

Any sensible manufacturer will produce a drug in a range that their clinical trials showed to be effective in the majority of people. Why on earth would they promote the drug based on a response experienced by a minority?

Suppression has been significant from day 1. A life changer. I went from totally obsessed with food every minute of being awake, using all my energy to fight the constant voice and feeling of hunger, to not being bothered by food at all and needing to make myself eat in one day. I've remained on 2.5, now week 6 and suppression only seems to increase as I lose weight, albeit slower now. The suppression feeling is heaven and I have so much more mental energy as a result. No side effects, at least nothing bothersome at all.

Low doses have been working well for me (14 weeks and 17.5 kg down), which I’ve vaguely assumed is because my brain chemistry was only slightly ‘off’ so it didn’t take much to correct it. There’s a complex mixture of genes and mechanisms behind obesity, and I suppose some of those mechanisms are more responsive to particular treatments than others. My reasons for overeating and for choosing high calorie foods were readily adjusted by this drug - I felt instantly and wonderfully different about food. I do also work with the medication by prioritizing protein for fullness, exercising a lot, planning careful regular meals and snacks etc, but I expect most people who are paying this much are trying to maximize the benefits.

Thanks for this thread. Its fascinating and has answered some of the questions I had whirring around.

I’m on week 5 and had first 5mg shot yesterday and I am just starting to feel suppression today.
So i literally had no appetite change, no food noise change at all for the first month - and no weight loss either.

Interested to see where it goes from here

I've been taking 1.25mg - on week 3 and have lost 7lb. I've been feeling nausea, burps, sweet taste in my mouth all the time and I've completely been put off alcohol and I'm normally quite a drinker (!).

I tend to over-react to ANY drug which is why I went for a small dose. I'm also very short which might explain part of that.

So I struggle to see that it's a placebo (although I wouldn't rule it out - the mind is powerful!). Frankly it doesn't matter to me because I'm losing weight for the first time in thirty years. I think the benefit for me is that the usual diet 'side effects' of headaches, exhaustion, cravings, faintness - are just not there.

I think those with super high initial losses are perhaps more likely to post online - they are happy and want to share their journey. If you look at the clinical trial data then losses of around 1lb a week are perfectly average, your 2kg a month is bang on target. It is working for you - just not as fast as you'd like. Comparison can be the thief of joy.

This fascinates me too. Before I started I was convinced I would be one of those people who'd have to go up to 15 in order to lose. I remember injecting the first time thinking it was probably going to be a huge waste of money!

I had savage appetite suppression from day 1 with the 2.5 dose of MJ. Never increased the dose for 5 months and lost weight slowly in that time, at an average of 1.8lb per week. It was my choice to lose slowly. I could have lost more quickly as I didn't want to eat hardly at all. Initially, I had to extend my injections to every 8 days just so that I was able to eat enough calories and protein for 3-4 days a week.

I also felt cold, tired and had horrible heartburn.

The reason I was fat was emotional eating. I've never had hunger issues. I ate to deal with unpleasant emotions. Hadn't really appreciated how much, until I couldn't. I also had some portion control issues, i.e. when I did eat, I ate too much and would clear the plate even when I was full. I wonder if our reasons have something to do with it?

I agree with a pp that a lot of folk who have success on 2.5, probably placebo effect. I have been on 2.5 for 9 weeks now, have lost 17 lbs so far. I do still feel hungry although I have no desire to eat crap but I do believe a lot of that is to do with the fact it's bloody expensive and I cannot see the point of being on it if I am still going to binge.

I have wondered this too; perhaps most of us have. Especially slower losers like me.

Weirdly I assumed I would be one of the faster losers, because I often have strong reactions to medications. But it’s affect has been minimal on appetite and I’m up to 7.5 mg. Just slightly smaller portions, slightly less desire for sweet foods (I’ll eat one biscuit instead of two). But like an earlier poster it all adds up, and over 18 weeks I have lost a stone without much effort.

I think my age goes against me (60s), my low exercise level (almost none) and thyroid issues. Also possibly dieting over the last 15 years. Plus “only” wanting to lose 2 - 3 stone overall. My diet didn’t change drastically as I already ate fairly healthily and my calories per day were already fairly low. I couldn’t really drop them that much more!!! Currently eat about 1000 calories a day - occasionally less.

On the positive side low weight loss means I am less in danger of losing muscle. I haven’t had too much in the way of side effects - I was very frightened of them as I often get very strong side effects to drugs and have to stop them. I went up very slowly. The first week I only dosed 1.25 mg. Even now I split the dose in two halves for the week. The one side effect I did get when I started the 5 mg dose were the two very bad skin rashes and hives I got on my arms with MJ. I assumed this was due to insect bites!!! I would probably have stopped if I’d realised it was an allergic reaction to Mounjaro (though classed as minor as didn’t affect my eyes or mouth or breathing). They lasted a few weeks, and were v itchy and uncomfortable but have gone now 🤷‍♀️.

I’m happy overall with MJ. Even though my weight loss has been modest compared to others, i.e. so far an average of half a pound to one pound a week including a few plateaus, I have never felt hungry or felt I had to “starve” myself or be unnecessarily focused on food.

PS. OP given your sensitivity I think you are doing exactly the right thing by going up very incrementally. I have done the same and believe I have avoided some side effects (of course not including my skin rashes and hives in weeks 8-11). I did experience nausea for the first time for two days recently and had to go to bed; it was a miserable experience I do not want to repeat so I understand your caution there.

I know you've said a lot of people and not all people but I don't agree with this. I am one of the people for whom 2.5mg worked for, for 5 months. I lost nearly 2.5 stone and I wasn't in the right diet mindset when I started taking it for this to have happened without Mounjaro, yet my appetite was gone. I also know it's not placebo as after 3 months on 2.5mg I started getting sulphur burps & 12 hours of D&V, despite still being on.the lowest dose. 2 weeks ago I tried a 3.75mg dose as I felt my appetite suppression was wearing off. The suppression was excellent but I also had 48 hours of awful nausea & vomiting. I've not jabbed for 2 weeks as a result, in the hopes of clearing the meds from my system, and am going to try 2.5mg today, and try jabbing every 10 days instead of 7 to see if this helps me aboid the side effects. I seem to be very sensitive to the effects of mounjaro and I'm sure there are many like me for whom the suppression & weight loss on low doses is not a placebo effect.